【摘要】 目的 探讨前列腺增生患者围手术期外周血T细胞程序性死亡因子-1(PD-1)表达对术后感染的预测价值。方法 前瞻性选取2017年8月至2020年8月邯郸市中心医院收治的150例行经尿道电切术前列腺增生患者作为研究对象，根据术后2周是否发生医院感染分为感染组(n=26)与未感染组(n=124)。统计术后2周患者感染发生及病原菌分布情况，比较两组血清白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、外周血T细胞PD-1水平，采用受试者工作特征(ROC)曲线分析血清PCT、CRP、术后3 d外周血PD-1水平对前列腺增生患者术后感染的预测价值。结果 术后2周，患者发生感染26例，感染率为17.33%,其中泌尿系统感染22例，消化系统感染3例，呼吸系统感染1例。共检出病原菌42株，主要为革兰氏阴性菌。感染组术后应用抗菌药物比例低于未感染组，合并糖尿病比例、前列腺特异性抗原(PSA)、WBC、CRP、PCT水平高于未感染组，手术时间和术后留置导尿管时间长于未感染组(P<0.05)。术后1、3、5、7 d,感染组PD-1水平均高于未感染组(P<0.05)。术后3 d外周血PD-1水平对患者术后感染的预测效能与血清PCT、CRP水平比较，差异无统计学意义(P>0.05)。结论 前列腺增生患者外周血T细胞PD-1水平对术后感染具有一定预测效能。更多还原

【Abstract】 Objective To explore the predictive value of programmed death factor-1 expression in peripheral blood T cells in of patients with prostatic hyperplasia for postoperative infection. Methods A total of 150 patients with prostatic hyperplasia admitted to Handan Central Hospital underwent transurethral electrodesiccation from August 2017 to August 2020 were collected as the study subjects, and they were divided into the infected group(n=26) and the uninfected group(n=124) according to whether or not hospital infections occurred in the postoperative 2 weeks. The occurrence of infection and distribution of pathogenic bacteria in patients 2 weeks after surgery were counted, and serum white blood cell count(WBC), C-reactive protein(CRP), procalcitonin(PCT), and peripheral blood T-cell PD-1 levels between the two groups. The predictive value of serum PCT, CRP, and peripheral blood PD-1 levels at 3 d after surgery for postoperative infections in patients with prostatic hyperplasia was analysed by using the receiver operating characteristics(ROC) curve. Results At 2 weeks postoperatively, 26 cases infection occurred in patients, with an infection rate of 17.33%, including 22 cases of urinary system infection, 3 cases of digestive system infection, and 1 case of respiratory system infection. A total of 42 strains of pathogenic bacteria were detected, mainly with gram-negative bacteria. The proportion of postoperative application of antimicrobial drugs in the infected group was lower than that in the uninfected group, the proportion of combined diabetes mellitus, the levels of prostate-specific antigen(PSA), WBC, CRP, and PCT were higher than those in the uninfected group, and the duration of surgery and postoperative indwelling urinary catheter were longer than those in the uninfected group(P<0.05). At 1, 3, 5 and 7 d postoperatively, PD-1 levels were all higher in the infected group than in the uninfected group(P<0.05). The predictive efficacy of peripheral blood PD-1 levels for postoperative infection in patients at 3 d postoperatively was not statistically different from that of serum PCT and CRP levels(P>0.05). Conclusions Peripheral blood T-cell PD-1 levels in patients with prostatic hyperplasia have predictive efficacy for postoperative infection.更多还原